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In this episode, host Lora Parent, Director of Strategic Partnerships & Research Development, welcomes Dr. Shanina Knighton (Nurse Scientist & Technology Innovator) and Dr. Elizabeth Pfoh (Health Services Researcher, Cleveland Clinic) for a candid conversation about timeless research methods, new technologies, and collaboration across generations in science.
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Transcript
“…If I'm so focused on what AI is doing and focused on, like what it is contributing to the world, and I lose sight of what it is that I'm doing in my growth, then it's like I become a part of that wave. And how do we begin to recognize when we're being influenced instead of being influencers?” - Dr. Shanina Knighton, PhD, RN, CIC
Lora Parent:
Well, welcome to episode two. From research to real Life. We are excited to be back for a new episode. Thank you so much for joining us today. We are talking about something. Every researcher, no matter the field, has to navigate methodology and technology. So what do we learn from the past? What do we embrace from the present? And then how do we take these two to form a better future for research and for outcomes in this field .I'm your host, Laura Parent. I am joined today with two fabulous researchers. Our first guest is Dr. Shanina Knighton.
She is a nurse, scientist and infection prevention expert whose work bridges, technology based interventions, implementation science and medical device innovation. She's a former case scholar and pilot awardee from the CTSC. And Dr. Pfoh, she's a health services researcher at Cleveland Clinic's Center for Value Based Care Research, focused on patient centered outcomes, care delivery and systems improvement. And also former K scholar. So…
Dr. Shanina Knighton and Dr. Elizabeth Pfoh:
Yay!
Lora Parent:
It's such a pleasure to have you both. And today we are talking about, methodologies and technologies and how they kind of shape our research choices, and how they kind of span across generations of researchers and how it has really, impacted both of you in your individual areas of research and interests.So I want to give you both the opportunity to talk a little bit about your research, your interests, and how maybe these things have, guided you over time and what you're doing as new technologies or new methodologies come in, across the paths, what you're learning from other researchers and how that has impacted you. So, let's dive into it. Let's start with you, Doctor Knight and Shanina, if I may. Okay. So you've built a career, and infection prevention and implementation science. Can you tell us about how maybe methodology has impacted your research? Talk to us about your research, what you're doing. And give us a little bit of an introduction to to where you are right now.
Dr. Shanina Knighton:
So that is a loaded question. So I always say, at the beginning. So once a nurse, always a nurse. And so my nurse and background is what led me here. As we can imagine, you know, we had H1N1, which was one of the first pandemics that I had experienced as a nurse. And so that kind of spawned me into infection prevention. And control. And so while I noticed all of these mechanisms for health care workers, there wasn't really many for patients. And so I always ask, you know, even at that time, I was a pregnant mom, how do patients keep themselves safe? And so as I continue to ask the question, asked the question, I found myself here at Case Western Reserve asking the question. And so that was during the PhD program. As you can imagine with methodologies, I was able to borrow, you know, from the health belief models, theory of planned behaviors. And over time, you know, just because things have happened, we're going into more of that implementation space, more of a space of where we're looking at translation. And so I started to use a different model, which is the behavior change wheel. And so what it does is, is it takes these theoretical domains and frameworks, including a health belief model, theory of planned behavior. And it puts it all into a combination. And so my work is around Combee, which is at the center of that. How does capability opportunity motivation lead to behavior change? And one of the things I'm focused on right now is patient hand hygiene. So how do we get patients more involved in being able to clean their hands at the bedside and then not only just doing that, but how do we get them to self manage? And so the ways in which I've been able to do that is implement technology in a way to where it's not always on the nurse to do everything, because whenever I said patient hand hygiene, it was, oh, just have the nurse do it. And I'm like, we don't need one more thing. And we all know we've been cleaning our hands since our mothers told us to, since we were babies. So it's really about how do you make sure that patients have that capability, opportunity and motivation to be able to do the behavior, which is to clean their own hands?
Lora Parent:
Wow. So it really started as a practicing nurse.
Dr. Shanina Knighton:
Yes.
Lora Parent:
And then kind of fueled your entire future career. This one maybe. Quick opportunity. Was it a patient? Was it an experience that you had that kind of really jumpstarted your your research question or your, you know, problem that you wanted to solve?
Dr. Shanina Knighton:
It was and, I know that there's always that saying about the butterfly effect and how things amplify. So I had, at that time, my husband's grandmother. So she had had a stroke, and she was only able to use the left side of her body, but she was a very meticulous woman. So we will watch her pick the dirt from up under her fingernails and ask for her hands to be clean. And then I had it again, with my mom. And so she was passing from cancer. And I'm like, well, why haven't you eat your food? And she said, no one's come in to clean my hands. And then being in the clinical setting, and this is when I was a novice at research, I literally would take tally marks and go around and talk to other nurses and say, did your patients clean their hands or did you have to tell them? Or I would even make note of when I had to remind my own patients. So I would say that those things is what kind of spawned it, and it just kept getting louder and louder, especially even now. I still have people call me and say, oh my gosh, my mom was in the hospital and she didn't have anything to clean her hands. But I thought about you and I made sure that she had something. So it still continues to invigorate me every time I hear those stories
Lora Parent:
Sure. Yeah, absolutely. And now, Doctor Foley's, Liz if I may. Yes. Okay. So you work kind of at the heart of value based care research and health services research. So what drew you to that space? And tell us a little bit about your interaction with research and what what was the one thing that that got you started?
Dr. Elizabeth Pfoh:
Let me just say I loved your explanation, Shanina. And one of the things that, like really saying to me is how you talk about how it's patients. And when we think about outcomes, it's really about helping a patient live a better life wherever they are at that stage. And like holding that. And to add my own story. The reason that I got into this is because my grandmother, had had a stroke and they were trying to decide whether or not to, put her into the hospital and do surgery, and she probably wasn't going to make it. And there was like this choice going on where like it made sense that of course she would do the surgery, but really, she wasn't sick enough. So, Shanina, as you talk about like, hand hygiene, it seems like, oh yeah, that makes sense. But in real life it's so much more complicated than that. So in my research, I feel very lucky to be here now where I grew up, working as a research assistant in New York City when they were implementing electronic health records. And it was this, like really interesting time where physicians were transitioning from paper to electronic health records and did that technology help. And it made sense that it would help. But sometimes physicians actually always physicians are really smart people, and they wouldn't use the system the way we anticipated because they did it. They used the system in the way that worked best for them to care for their patients.And then we'd have these all unintended outcomes. And, I built my career over time working with electronic health record data, which is a little bit more digital than your work, which why I but we need estimates. Meaning. Yeah, we need both. Yes. But to understand like what patients are up taking care what patients are given being given different types of care and trying to understand the why. So a patient might not be given our certain and what we would deem high quality care because maybe that's not what they want. That's not who they aren't. Patient centered care is also really important. So trying to tease that out, now that we have electronic health record data on like, large, populations of people, I think that is my job.
Lora Parent:
So talk to me about how you have blended maybe things that you used to start with. So you know, as early back as the pen and paper, keeping tally marks, with EHR you know, we are taking voice notes, we are scribing in one notepad and then we're transferring to another. And so how do we maybe effectively blend both technologies, both our technologies in a sense. Right. The pen and paper is the technology. And typing into the computer is another. So how do we merge those two. But then also do that with efficiency, quality control. And, and making sure that everybody's working on the same page.
Dr. Shanina Knighton:
So I can tell you, one of the challenges that I had as a nurse is, and I'm sure that physicians are the same way, is that when you're doing documentation, we learned how to, I would say, do a shorthand documentation. So the way in which I may put in notes may not necessarily be the boy ran to the store. It's going to be context clues of words that still want to get to the end point. But somebody in the medical field would be able to read that. And so now what we're saying is, is how does that change, like the level of writing. And so EHRs, being able to recognize that shorthand, right. And and being able to translate it into something is accurate, I think is a way in which it could be useful and helpful.I think that would be my biggest take on it, in terms of how it would be useful.
Dr. Elizabeth Pfoh:
And, with that, I would say carefully, right. Like you, you try and use. Net new technologies, especially if we think it can help patients get better care. If we think it can help ease caregiver burden because documenting within the E.R., is a lot and it can lead to burnout. And that's not necessarily providing care. Right. So how can we make sure that we're building a system and a process that helps patients have the best health possible? But when we implement it, we have to evaluate it. Right. And we have to think carefully about is this doing the thing we think it's supposed to do? Are there any processes that,might be unintended consequences, like something gets missed or something that gets documented that way? And when it and I think it's everywhere, I will say I went to the vet recently and they started using an AI scribe. So it's coming, adapting it and making sure that it, improves things is really important instead of taking away.
Dr. Shanina Knighton:
Yes, I agree with the assumptions too. And so and I think that's one of the biggest things is that, AI is in a way like it makes a lot of assumptions, and sometimes those assumptions can turn into biases that may not necessarily reflect the care as needed or the care that's given. And so even, as I describe it now, just within health care, particularly related to nurses, is I think our health care system is more reactive instead of proactive. And as a reactive, we as a reaction to everything, there's a new technology, there's something that's trying to be implemented to be able to improve safety, but those very things that are intended to improve safety are actually leading to those unintended consequences. And doing the opposite of what it's supposed to do. And when we think about like, let's just say human implementation of it, they say that like literally we're having proliferation without integration because it's very hard to get someone's brain to be conditioned to their existing workflows, being able to put into the mix. Also, this new technology that now they have to become accustomed to learning, but then they're already inundated by making sure that they accurately document what is needed. And sometimes those technologies that come in the way in which I may be trained as a provider may not necessarily translate with what it is this technology is doing into the system. So if this technology is doing that work, it very well may leave out some key indicators that I would have documented as a key step. That could have been very helpful to, let's say, maybe an early warning sign for a patient.
Dr. Elizabeth Pfoh:
I think that's exactly right. I have two points to build on what you said, one with like how we think if we are given a story, then our mind wants to fill in the blanks of that story. Whereas if it was a blank page, we might think more expansively, I'll tell you. I recently got an AR 34, and we were thinking, and yeah, so excited. Thank you. NIH. And we were filling out the ClinicalTrials.gov, and it's very focused on a patient level clinical trial, but I'm doing a unit level clinical trial. So the person who is helping me figure it, fill it out, like kept getting into this, this doesn't feel right. Right. Because she was getting pigeonholed into what probably made sense at the time but didn't fit my problem didn't fit my clinical trial .And that's what happens, sometimes in care where you're given like this answer and you have to answer the questions. And these are very busy people who are very smart but have to practice a lot. And our human brains only process so much at a time. So I think your point about what we give and then wickets documented versus thinking more expansively, I think it's really great.The other part I wanted to bring up was how you were talking about how different people document, and we all speak differently. You'll notice that there are some words I say like idea that are incorrect and my friends find hilarious. But if, when you are documenting the AI algorithm is built on like one set of a population, and we have a really diverse set of health care providers across the nation who might speak and document differently than what it was originally built off of and understanding.Like, how much does this algorithm generalize to our patients and our clinicians, and how they type and think, I think is really important. So I just wanted to agree with that comment in
Dr. Shanina Knighton:
I love it because I mean, just in terms of how you framed it, they just gave me a different way to frame it. So thank you.
Lora Parent:
So talking about AI a little bit, it seems as though it's, it's just moving so fast. How do we handle the fact that maybe it's moving a little bit faster than we would like and we're not able to put in maybe, some methodologies that would have a standard level of, of care or baseline for providers or for nurses inputting information into machine, the system, and giving us different outputs all around. How do you combat that?
Dr. Shanina Knighton:
I would say for one, being true to yourself and being aware of where you are and is not to say ignore AI because AI is here. But I think the more we come to understand it, then the more we come to understand ourselves and how we do continue to have, I would say, critical thinking and independent thought. Meaning that if I run a math problem, let's say myself, and I'm doing it by hand, and then I'm like, okay, let's see what AI has, it's okay for me to still believe in my own results if I follow my own methodology. And I just think sometimes with how things are built and how fast it's going, we understand that systems are sophisticated.I understand the statistical analyzes is going to be maybe way far sophisticated than what I learned in my PhD program, and what I continue to practice right now. And it's okay for me to continue to be where I am and process it based off of that level. And so I think, comparison is the thief of joy. And so the challenge is, is that we have to ask ourselves, am I being true to myself and my level of growth as a scientist, or am I being influenced by something that I'm not prepared to embrace or understand? Because they say, if you're not a part of the solution and you're part of the problem. So if I'm so focused on what AI is doing and focused on, like what it is contributing to the world, and I lose sight of what it is that I'm doing in my growth, then it's like I become a part of that wave.And how do we begin to recognize when we're being influenced instead of being influencers?
Lora Parent:
Oh I love that.
Dr. Elizabeth Pfoh:
And I love how there is like trust yourself in there, right? Like if this doesn't seem right, and I think that goes back to the earlier conversation, if something's missing, if the numbers don't seem right, what's going on? And for me, as someone who, is a researcher by training, not a clinician working with my clinician partners oftentimes and saying, does this number seem true to you? Is this low? Is this high? What's going on? And I think we do have a lot of methodologies that we can use and apply. And I will say I have a 50% operational role. And I and I use a lot of the skills I have as a researcher to do these, like rapid cycle analyzes operationally to say, like, are we missing people are who we have this identified list of high risk people, are there other people who should be in there shouldn't be in there. And that's just, using regression analysis and like looking at the data and looking at the populations.I still think that a good graph tells a huge story. And, it's not advanced, but it helps us understand the world, especially as bring including AI in it.
Lora Parent:
What have you both seen as maybe some of the biggest hurdles trying to either implement something new because we know it takes, you know, the standard of 21 days, right. To adopt a new habit. We've heard all of these kind of theories about adapting to change. It is very hard. We are creatures of habit, down to the core.
Dr. Shanina Knighton:
I laugh because you talk about 21 days for a habit is 17 years, I want to say is the average, for uptake of a change in practice? Yeah. And a lot of that is culture is one thing. We also have to be cognizant that the landscape of health care is changing. And so whether it's becoming more preventative, resources, you know, are shifting. So things are happening and it's gonna automatically mean that we have to look at things a little bit differently than what we have. And so there's always going to be competing priorities. And so I'll tell you, even with my area of research with Liz’s area of research and what it is that we're doing, some may say, hey, you're doing something that may sit on a shelf for years, or it can very well be something that literally they're going to say, hey, you know, Doctor Fau's research is valuable in this particular moment. And her methodology, we need to pull it back off of the shelf if it was on the shelf or she's still working on it and maybe there's this piece that needs to go with it could be the same thing with mine. But I think the thing is, what keeps us motivated is that some of these problems are still not resolved.And so as I'm looking at self-management, we saw with the pandemic, infection prevention is not just a hospital based thing. It's not just something that happens. You know, when you're getting care, it's going to happen in the community. It happens at the grocery store. It happens absolutely everywhere. And so my thought process and how I move is how do I move it beyond just the laws of research.How do I move it beyond just a publication? And more so importantly, we are good stewards of taxpayer dollars. So how do I make sure that the work that I'm doing is actually going to get to everyday people? And so that is my biggest thing of what it is. And I'm focusing on now of as long as I continue to reiterate the message of how infection prevention fits into our daily lives, use evidence based practice. Use science to be able to do that, then it's like by the time we make it to that 17 years, it's like it's something that's been building up instead of me waiting in order for it to be embraced. So I would say that that's how I overcome the challenges is understanding that is not necessarily, a hurdle or a challenge.It's a marathon.
Lora Parent:
Yeah.
Dr. Elizabeth Pfoh:
So before I talk about my research, I want to actually go back, Shanina and I were K2 scholars together, which was like such a joy for me and learning. But one of the things I remember, and hopefully I'm remembering correctly, is that you did a lot of testing, too, when you were building hand hygiene, and one of the things that I was thinking as you were talking before is hand hygiene makes so much sense. But after you explained why it's difficult and why it's difficult for a hospitalized patient, and that difficulty might be different for different hospitalized patients, I was astounded about all the things I didn't think about. So would you mind sharing a little bit about how you did some prototype testing to make sure that it was uptake?
Dr. Shanina Knighton:
Yes. Thank you for that. So, the technology that I'm currently testing out right now, with the R1 through National Institutes of Aging, I'm in year four is a patient's more a hand sanitation dispenser that affixes to the patient's bed real. And it reminds the patient when and how to clean their hands. But it gives verbal reminders opposed to the standard beep and that they would experience.And so what Liz is mentioning I didn't start there. So it took, you know, my CTC pilot funding, it took the Cahill two scholars funding. So it took this building up in order for me to be able to get there. So it started out, you know, I showed a video during our scholars program, and it was a video of a patient that was struggling to open up the towelette, and it literally took them about two minutes to open it. He spoke about the neuropathy in his hands. He talked about wanting to be independent and not wanting nurses to do it. But then after I spent that time of him opening up that packet, I cut the video off and I remind people that he still had to unfold it eight times before he could use it. And so someone that is weak, they're hospitalized. That's going to be hard for them to use that towelette. So I thought about that. I tested out wipes. And so I had done an intervention of where they put wipes on top of the tray. Patients complained about, drying out before using them. So I'm like, okay, well, maybe that's not convenient. We tried, the pocket size hand sanitizers.They had issues with flipping the cap up because they strengthened our hands. And so then when we settled on a push down pump that we would put it on a bedside table, but the table would move around because, of course, the priority is for caregivers to be as close to the patient. So then if their bedside table was in there, they still couldn't clean their hands.And so all of these things is what ended up us coming up with a design that would be within close proximity to the patient, testing out beep and reminders. There's a lot of beeping already, but if there's a sound, you know, and it's Mr. Jones, can you llplease clean your hands and is directly talking to them? I can now augment the voice of my provider and telling me to do these things, as opposed to me listening to another beeping sound and me having to remember to practice, which again, we know patients. It's not that they don't want to, they're just not in that right mindset. So thank you for that.
Dr. Elizabeth Pfoh:
I was so impressed hearing about it. I love how you're meeting people where you're at. Me I do get a masters. And when I learned in my Masters of Health promotion is essentially people do what might seem irrational, very rational reasons to them. So to answer your earlier question, what we often do is look for differences like look and see who is up, taking it a lot and who's not using it at all. And then we talk to them. Why do you like this? What's, what is useful to you? What are the perceived benefits? What is the culture? What are your leaders saying? How does this fit into your workflow? And then we talk to the individuals who are not up taking it. What are your perceived benefits? What are your perceived barriers? Where do you spend your time instead? Because oftentimes someone's not doing something because they value something else. And that could be, honest, true evaluation of what that something means to them..
Lora Parent:
AI can't do that.
Dr. Elizabeth Pfoh:
Correct.
Lora Parent:
Yeah. So let's talk a little bit about your future.What are some things, whether it be, new technologies, whether it be new methodologies, maybe new opportunities for AI, collaboration. What are some things that you are looking forward to? That will, you know, help your research, help your products, help, implementation of the work that you've already done.
Dr. Shanina Knighton:
I want you to start,
Dr. Elizabeth Pfoh:
I will say I'm super excited to be here. I just essentially like mid-career. And so one of the things I'm excited about is this uptake of natural language processing AI models. And I will say, earlier in my career, I heard about natural language processing, and it just seemed, too specific to where the population. So there has been a big move where it is way more generalizable. So how can we make care better when I'm also interested in subpopulations. So as we think about population based health, you can move the health of the entire population and leave some populations behind. So as we look at AI and how it's helping hopefully and evaluating that, both operationally and research wise, is anybody left panning left behind. Why and how can we help move them along too? So I am particularly interested in that. And mixing this large data that we have that we can understand populations, what they're using and what they're not. With talking to people. One of the other things I'm really excited about, I've been working with Doctor Dalton and Princeton ski on an Arc grant that they have, where we're also looking at, community factors. So how does where you live impact that carry your accessing your, diagnoses, etc., so that we can understand that maybe it's harder to access care in a particular place. Maybe it's easier. So thinking more broadly on how to help people.
Dr. Shanina Knighton:
I love that,.you brought up something that I think is exciting, and that is because you do see the focus. It's you hear these terms very like big data, big data, big data. And then it's like you're capturing the big data, but then oftentimes those other populations or the smaller factors that are impacting maybe a few get forgot. But that is sometimes something is interesting because it tells a bigger story. And then when you see problems that start small or they start with small populations being able to say, how is that growing over time? Because oftentimes that's something that's missed, where it's like, okay, well, yeah, maybe 2000 people started at this, but then you're checking back five years later and you're like, oh, I just query this, and now it's 12,000 people that are in this category. And it's like, what has happened in order for that to be able to increase. So I'm excited that I'm going to use the term of, you, not necessarily, it's not a term, but just the fact that you're not forgetting about the forgotten. Yeah. In regards to the approach that you're taking, which I think is very exciting.
Dr. Elizabeth Pfoh:
Thank you.
Dr. Shanina Knighton:
Yeah. So
I love that
Lora Parent:
We've seen a lot of retroactive studies being done, through the CTSC, because now EHR has the capabilities to kind of look into a window of the past. And so I think that's, that's really great because now we're able to see things that maybe we weren't beforehand. And make some tweaks along the way. Get those early adopters, maybe there's something that we forgot along the way because we weren't aware of either the numbers or the processes. From that information.
Dr. Elizabeth Pfoh:
That's exciting you're funding that.
Dr. Shanina Knighton:
Yeah.
Lora Parent:
Well, that, informatics is is the hot spot right now. So, we do have a lot of interested researchers, you know, coming into that area using the genetics, using the cosmos, to start their research and a lot of students showing interest in that. So we're excited for that.
Dr. Shanina Knighton:
I would say. Next for me, I've learned or I'm learning a lot. And I think one of the things as I am going through this process of medical device implementation, it makes me think about the implementation. So even as I've gone through this space and I'm like, hey, I can put this at the bedside, right? And this is something that can be done. How do we kind of meet the health care environments where they are to make sure that people are still getting good care, but it's not necessarily dependent upon, let's say, a facility needing to purchase something. The other thing is, as I mentioned, just with this space of thinking about infection prevention, self-management amongst patients, I started with older adults and it's like now it's grown beyond just the hospital. So I've looked at pathogens being on patients hands that are inside of the hospital. We've looked at outpatient, we've looked at, you know, individuals that are, let's say, maybe going into surgery. So I know, like the ones that are admitted, I know the ones that are outpatient, I know the ones that are coming in. I know that they have pathogens on their hand which are deadly germs that can lead to infections.So now it comes down to the home environment. And what in the home environment can be potentially influencing those pathogens that can translate into infections. So my area of interest that I am now getting into and have been maybe for the last three years, has been specifically around hygiene, poverty and just the inability for people to be able to afford environmental as well as personal hygiene items.And how is that influence and health outcomes, particularly as it relates to, high end or increased risk for infections.
Lora Parent:
Yeah.This is a little maybe off script, but I'm curious because of, the influencers that maybe you had talked about previously, and there's a lot of misinformation online as well, people who are self prescribed doctors on the internet. Or, you know, the doctors who do put themselves on doc talk, to, you know, give the tips and tricks.How does that maybe negatively impact what you are both trying to achieve?
Dr. Elizabeth Pfoh:
May I add first
Dr. Shanina Knighton:
Go for it.
Dr. Elizabeth Pfoh:
So one of the things about electronic health record data is we only have data on patients who show up and the care they receive. So one of my interests is in depression. And some patients receive depression treatment within our health system. Some patients receive it and other health systems are outside providers. Some patients receive it online. And I have to be acutely aware of being a person of patients. I expect to receive it in the health system and then, like missing not at random that who is missing and why.And to go to your point about, hand hygiene at home and increased risk, some patients might be at more increased risk based on other outside factors besides them. And how you think about those like influencers, that could be receiving care online. It could be living in a particular area. It could be having something else that it's that makes it more or less important that hand hygiene is probably always important as well.
Lora Parent:
I could also see somebody saying,you know, I saw it on the internet. You know, you hear that phrase so much. Well, I saw it online or I didn't have the money, so I saw this fast track or this shortcut, to do it myself. And so have you, you know, maybe experience that yourself.
Dr. Shanina Knighton:
Somebody could live in deplorable conditions and may not have resources to, let's say, cleaning supplies, like in their environment. There's basic things that can still help them to be able to clean that. Unfortunately, sometimes a standard way of doing things is the more expensive way of doing it, as opposed to being able to provide something that's maybe an economical option that's going to decrease their risk, steal. So it may not get rid of it completely, but is still an option, is going to put them in a safer condition than what they would have prior been in. I'm always going to say, so one of my mentors, Doctor Mae Weichel, said publish or perish. And also, as I mentioned before, just continuing to do the work, I will tell you,as you can imagine, even with everything going on with health care, Covid, you know, you often get the naysayers to misinformation and disinformation that information is going to come but I remind people, I'm doing the work.I'm there. I have firsthand knowledge. I'm sharing the data in a way in which the communities can be able to understand that's the best, honestly, that we can do. To be able to, let's say, counteract that is to just continue to be ourselves and continue to do the work. Because there is going to be that I will be honest. I have it within my own family. I'm a nurse, okay? And I'll make recommendations on when somebody should go get preventative care. I'll tell somebody like, hey, you probably should go get that looked at. And guess what? They don't listen. I love them, but they don't listen. And even to like you could, you know, I'm sure do the same thing and so.
Dr. Elizabeth Pfoh:
Oh I do to my parents.
Dr. Shanina Knighton:
Exactly. And I say that they become our kids. Right. Like as they get older. And so I do believe that. And you again are the trusted voice. You're you're in health care. Yeah. And so to say that like we experience it all in our day to day lives, that it prepares us for the rest of the world who may not be ready, but you can just reach somebody one message at a time. Being responsible in regards to what it is that you're sharing, making sure that you are part of the solution is not necessarily a part of the problem. Just because there is going to be the overwhelming noise, and you are going to have people, you know that are pseudo doctors because they have access to ChatGPT and all of these other things that just pretty much kind of like tell them like, oh no, this is what I said I need to do.I need to Jimmy rig this. I need to fix this knee this way. So we just know that is going to be out there. But as providers, as scientists, as nurses, as researchers, when we're looking at data, just doing anything, we just have to make sure. Am I being a good steward of this? Am I making sure that I'm providing the most accurate information? And am I being honest of when I don't know what I don't know? And as long as we're in that space of knowing that science is about discovery, it is about asking those questions instead of having the answers, then I think we'll be fine. I think we'll out what I think we will out ride the wave of misinformation and disinformation.
Lora Parent:
Great. I couldn't, I couldn't have said it more perfectly than that. And Liz, is there anything that you would like to say to maybe future researchers, about what's to come? You know, I think she said it perfectly. It's kind of stay true to yourself. you know, believe in what you believe and really stick to that path. What else could we impart? What wisdoms do we have?
Dr. Elizabeth Pfoh:
I get the joy of working with medical students often times at or, meeting with people. I think talking to multiple mentors, understanding, their pathway to what extent their pathway works for you to understand what their methodology works for you. There is always, benefits and pitfalls to every methodology. So understanding what you're picking and why, who you're learning from what their biases are. Because I have my biases right. Like we all have them, and being able to say like, this is what I want to do and building that path forward and understanding the path is not linear. You are going you're going to meet roadblocks, you're going to get rejected. The R 34 I just told you about, I will say it was probably rejected four times locally before I got it funded by NIH. And normally you would say if it's not funded locally, why go to NIH? But like believing in yourself, believing in the idea, and then also saying like, hey, this isn't working for people. Why? What? What am I missing in my narrow perspective that I need to add so that somebody else can see what I'm trying to say?
Dr. Shanina Knighton:
So that's see and it sounds like some self-reflection. Yeah.
Lora Parent:
Well, thank you both so much for an engaging conversation today. I really enjoy this, and I would love to stick around for another hour asking more questions. But unfortunately, we are out of time today. For our listeners, we would love for you to get engaged with the CTSC. If you're interested in funding, core support, training methods, emerging technologies that, visit us online on our website, of course, subscribe to our podcast and share with your colleagues who are exploring new research tools and looking to explore new connections. And actually, we do have a fun announcement that our K just got funded again. So we are excited to maybe have a new future K scholars, coming onto our podcast in the future. So thank you both so much. And we look forward to seeing what's next. Yeah. And the calcium program is awesome
Dr. Elizabeth Pfoh:
And the K12 program is awesome.
Dr. Shanina Knighton:
Yes, I have to give absolutely high recommendation..
Lora Parent:
Wonderful. Thank you both so much.